Are you making therapy happen? Can your sessions be heard in the next state because you’re speaking so loudly? Are you EX-AAAAAA-GER-RAAAAAA-TING the WORDS so LOUDly and unNATuraLY that even a person with typical hearing would have trouble deciphering your message? Do you leave the session sweating because of the song-and-dance routine you’ve just performed?
…um, maybe it’s time to take it down a notch.
I think that there’s a common misconception that MORE means better when it comes to therapy. We all slip into it from time to time, and it’s difficult, while juggling goals, monitoring current levels, managing behavior, coaching parents, etc. to also be cognizant of our own pragmatics. It’s easy, especially when a child isn’t getting a particular concept, to think that raising our voice or exaggerating our syllable stress will push them over the edge of understanding. Sometimes, it is appropriate — that’s called acoustic highlighting. But sometimes, it gets way, way out of control.
…and that’s actually COUNTERproductive. When you raise your voice so loudly, the vowel sounds begin to overpower consonant phonemes (speech sounds), which are naturally quieter (think about what you hear though a megaphone at a football game — it’s mostly vowels, you just fill in the consonants of a phrase you already know). It also impacts your co-articulation, or the way that sounds are said when they are together in words. Think about the word DOGS. If you said it exactly as written, the last sound would sound like /s/, but now say it out loud, and you’ll find that the last sound you say is actually /z/, which is usually the case with plural -s following a voiced phoneme like /g/. I cannot tell you how many times I’ve seen this done by a well-meaning therapist who, in his/her eagerness to be super-correct, actually ends up teaching the child to pronounce the word incorrectly. Is it irreversable? Will the child NEVER figure it out? Of course not, but a professional whose JOB is listening and spoken language should be able to separate the “meat” from the “show” and get it right.
Not only does exaggeration impact that acoustic qualities of phonemes, it also affects your articulatory patterns (how your lips, teeth, tongue, etc. move when you speak). Now, there is debate as to whether the child should be looking at your mouth at all, and I would argue against it, feeling that it robs the child of the auditory experience and the gift of learning to produce the sounds more naturally through audition BUT if you, as a therapist, have evidence and research to support your claim this child with hearing loss should learn speech through looking, not listening (perhaps the child has NO auditory access for some rare anatomical reason, like no cochleas and no ABI), I beg you — watch your mouth! Are your articulators moving in hyper mode? When you say /Θ/ (voiceless “th” as in “think”), your tongue is usually ever-so-slightly between your front teeth, but has yours made it out into space, as if you’re sticking out your tongue? If so, what reason do you have to think that your student will produce it any other way? Most phonemes are NOT visible, and by making them able to be seen, we often lose the correct placement that leads to a more natural sound.
Another danger of this over-exaggeration is tricking ourselves into believing that a child understands a phrase or concept when, in reality, he was “led” to the correct answer by our chunking, stressing, or mime-show gesturing. Again, to establish success, some of these techniques, in moderation, can be just fine. But when push come sot shove and you’re trying to determine what the child knows through audition alone, make sure you’re presenting the stimulus… through audition alone. You can do it, it’s not complicated! It just requires catching yourself before you start to put on a show.
And the last, perhaps most disappointing, side effect of “putting on a show” is that it makes the therapy process more about the clinician than about the child-caregiver interaction. If you’re on stage, you’ve relegated the parent and child to passive roles as your audience instead of empowering them to drive the therapy experience.
We all have our “center-stage” times when, if we can stop and take a breath, we realize that we’ve carried the show a little bit too far. That, in and of itself, is not so bad. It’s the ability to pull ourselves out of the starring role and back into guiding and coaching that saves the session and puts the real stars — the children and their caregivers — back in the leading role.
Elizabeth A. Rosenzweig 